Thursday, August 18, 2011

Syracuse Restaurant Becomes "Pharmaceutical Dinner Facility"

In a rather embarrassing attempt to raise revenues, a restaurant in Syracuse, New York, is now explicitly marketing itself as a purveyor of drug company dinners.

Francesca's Cucina, "Located in the heart of Syracuse's Little Italy," according to its website, offers a private banquet room, a private outdoor courtyard, and regular tables and a bar to drug companies wanting to use fine food and alcohol to convince doctors to prescribe their drug over a competitor's drug.

Massachusetts passed a law banning such tactics in 2009, and I have posted about restaurants' unsuccessful efforts to repeal that law. In one post, I coined the term "trickle down deception" to describe restaurant owners' rationalizations of drug company dinners. This is the unfortunate process in which otherwise moral business owners blind themselves to the ethical implications of their decisions. The deception supply chain trickles down from manipulative promotional plans of drug companies to hired gun doctors, restaurants, advertising companies, medical writing companies, etc.... Basically, if the money's out there, someone will grab it.

I'm assuming that Francesca's Cucina makes a bundle on these dinners, considering the fine meals they are encouraging drug reps to buy doctors:

Yes, as they say on their website, "Francesca's Cucina is the premier facility for pharmaceutical dinners in the greater Syracuse area." It's a sad state of affairs when a restaurant brags about such a thing.

Pharmaceutical company dinners are of great benefit to patients. They should be a source of pride for any restaurant, helping large numbers of patient in large clinical practices.

1) Doctors and other professionals gather to share information, often with a prominent speaker.

2) They get an opportunity to straighten out any illusions about the standard advertised advantages of the new medication.

3) Doctors inexperienced with its use can skip the mistakes others have made and learn its more sophisticated applications.

4) Drug companies get intense discussions about off label discussions, which comprise half of all standards of due care. Companies may then get ideas to support these applications with future research and FDA applications.

5) If one adds the time and trouble to attend these dinners, they far exceed the value of the meals. These dinners represent a considerable economic sacrifice by all doctors and professionals attending, to achieve an enhancement in the use of the product back in their clinical practices.

Dr. Carlat does damage to clinical care by his relentless biased, propaganda campaign against industry sponsored doctor activities, such as dinners, conferences and CME. He has no evidence of any harm to any patient. While there is plenty of personal experience of much mutual learning taking place, between doctors, and between doctors and drug company.

Example? Start Risperdal 1 mg, then 2 mg the second day, then 3 mg the third, then 4 mg. Any doctor who followed those company directions did so only once (like yours truly). You got catastrophic results.

The company learned from these meetings, and recommended far slower increases, and started to produce pills at much lower doses, based on doctor feedback about their experiences.

I attended a couple of these events some years ago and didn't find them to be as helpful as Dr. Behar does, and I haven't gone in years. Seeing colleagues that I didn't see anywhere else seemed to be best reason to go at the time. I'm curious, though, about what Dr. Behar means by "These dinners represent a considerable economic sacrifice by all doctors and professionals attending" though. I only went at dinner during a time when I wasn't earning money anyway, and didn't see a sacrifice that anyone made by being there. It also seems to me that if points 1-4 are all true, that point 5 probably shouldn't be true, and if 5 is true that points 1-4 shouldn't be; they seem inconsistent to me.

Anonymous: Within 6 months of the release of Zyprexa I attended a 4 hour industry sponsored meeting where 90% of the time was spent on the Metabolic Syndrome. I had never heard of it. So I was carrying out most of the current screening and management guidelines 10 years before they were issued. This included a tip by an endocrinologist, sitting next to me at the dinner table, to measure insulin levels even if the blood sugar is normal, as an early warning of strain on the system.

I was still working on an inpatient service, and using mostly Zyprexa to get people out quickly. That sobering meeting resulted in a lower fraction of patients getting Zyprexa, rather than the commercial interest of getting a higher fraction prescribed. For example, overweight patients no longer received it, except after failing to respond to others.

Arid: My professional time is worth quite a bit.. Half hour to get there, half hour to return home. Four hours of conference time. That is worth at least $1500 if not $3000 due to the clinical experience advice they received. We got paid $1000.

As to $50 dinners, lasting 2-3 hours? The sacrifice is ridiculous. It should be deductible as a charitable donation.

A lot of these companies are European. They are ultra-stingy, and denigrating of the value of clinician time, from their culture of Commie Care in Europe. If it was for the money, and not for patients, I would not attend any of their functions.

Their stinginess is more likely to induce resentment at being exploited, and hostility to the drug. No one I see at these conferences is happy. Everyone is bitching about the drug. If the pay were appropriate, there would be more smiles.

As to those away conferences, they are even more of a waste of unreimbursed time than the dinners. Now they are consuming an entire two or three days.

"Their stinginess is more likely to induce resentment at being exploited, and hostility to the drug. No one I see at these conferences is happy. Everyone is bitching about the drug. If the pay were appropriate, there would be more smiles."

Did he just say what I think he said???? Happiness with a drug is directly proportionate to the amount of money the doctor is paid for learning about the drug.....